Provider Demographics
NPI:1962184200
Name:REGINA WALSVIG, MARRIAGE AND FAMILY THERAPY, INC.
Entity type:Organization
Organization Name:REGINA WALSVIG, MARRIAGE AND FAMILY THERAPY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:REGINA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:WALSVIG
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LMFT
Authorized Official - Phone:949-307-8367
Mailing Address - Street 1:901 DOVE ST STE 150
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-3018
Mailing Address - Country:US
Mailing Address - Phone:949-649-6066
Mailing Address - Fax:949-276-3083
Practice Address - Street 1:901 DOVE ST STE 150
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-3018
Practice Address - Country:US
Practice Address - Phone:949-649-6066
Practice Address - Fax:949-276-3083
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-04
Last Update Date:2023-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty